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Nursing 2 > Joint & Connective Tissue > Flashcards

Joint & Connective Tissue Flashcards

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1
Q

assessment for joint/connective tissue problems include

A

gait, posture, functional assessment (observe activities like transfer to chair, dressing/ADL)

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2
Q

ESR is

A

rate of sedimentation of RBC, inflammation causes clumping of RBC so higher ESR level an indication of inflammation

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3
Q

antiarthritic drugs: 3 categories

A
  1. NSAIDs, non-steroidal anti inflammatory drugs including aspirin
  2. DMARDs disease modifying anti rheumatic drugs
  3. glucocorticoids - adrenal corticosteroids
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4
Q

inflammatory connective tissue diseases: 3

A
  1. RA
  2. SLE (systemic lupus erythematosus
  3. Scleroderma
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5
Q

serum lab tests:

A
  1. ESR
  2. Uric Acid
  3. ANA (antinuclear antibody)
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6
Q

3 goals of rheumatic disease

A
  1. suppress inflammation and the autoimmune response
  2. control pain
  3. maintain or improve joint mobility
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7
Q

osteoarthritis definition

A

chronic, causes cartilage deterioration in synovial joints and vertebrae.

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8
Q

osteoarthritis affects

A

weight bearing joints: hips and knees

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9
Q

osteoarthritis pain: when?

A

worse with activity, better with rest, not usually at night

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10
Q

crepitus during ROM activity

A

sign of OA

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11
Q

herberden: definition

A

enlarged upper joints of the fingers/DIP joints

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12
Q

bouchard: definition

A

enlarged lower joints of the fingers/PIP joints

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13
Q

radiographic/X Rays show

A

osteophytes - (bone spur) bony growth at the end of a bone

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14
Q

MRI show

A

cartilage, synovium and bone

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15
Q

osteoarthritis interventions:

A

no treatment to stop degeneration of joints so

  1. educate
  2. reduce pain and inflammation
  3. maintain function
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16
Q

NSAID risk

A

GI complications

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17
Q

arthroplasty and osteoarthritis:

A

surgical repair of the joint

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18
Q

intra-articular injections

A

hyaluronic acid - acts as synovial fluid in joint space

corticosteroids - methylprednisolone

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19
Q

hot or cold treatment timing

A

20 minutes on/off

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20
Q

gout: definition

A

urate crystals deposited in joints, problem with purine metabolism > hyperuricemia (high uric acid in blood)

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21
Q

primary gout: definition

A

genetic, overproduction of uric acid or decreased urate excretion in the kidney

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22
Q

secondary gout definition

A

also hyperuricemia, diabetic ketoacidosis (DKA), starvation

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23
Q

tophi: definition

A

urate/uric acid crystals deposited in peripheral areas like great toe, hands or ear.

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24
Q

acute gouty arthritis: definition

A

recurrent attacks of joint inflammation/ acute arthritis

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25
diagnostics for gout: 4
1. uric acid test, 6.8 is gout 2. 24 hour urine collection 3. x-ray 4. aspiration of fluid from inflamed joint to see crystals
26
gout ice or heat?
ice
27
gout medications
chochicine (colcrys) - interfere with function of WBC so no inflammatory response
28
chochicine (colcrys) side effects
diarrhea, take with meals,
29
gout nursing interventions
1. pain mgmt - cold compression 2. hydration - avoid kidney stones 3. diet - avoid pureens (organ meat, alcohol, red meat) 4. healthy weight
30
rheumatoid arthritis unilateral?
no, affects both sides at same time
31
RA sign
morning stiffness for an hour before pain
32
RA causes
1. rheumatoid factor (RF) antibodies form against IgG | 2. synovial membrane destruction leads to pannus
33
RA signs
deformities of hands and feet fatigue weight loss Raynaud's
34
arthrocentesis
RA diagnostic, synovial fluid analysis
35
swan neck deformity
deformed position of the finger due to RA
36
RA labs
``` RF high Anti CCP high ESR high ANA high RBC lower ```
37
DMARDs
methotrexate - anti inflammatory, give with folic acid supplement, s/e aplastic anemia
38
saline eye drops for
RA
39
connective tissue types include
bone, blood and organs
40
ESR diagnose? evaluate treatment?
not to diagnose, evaluate
41
intercritical symptoms?
no
42
gout in the great toe called
podagra
43
uric acid level signals gout
6.8
44
gout and kidney stones (uric acid filtered by kidneys)
purines make up 15 percent of uric acid, uric acid > gout and kidney stones
45
colchicine/Colcrys timing
must be taken within 24 hours of onset of acute gout attack
46
XOI (Xanthine Oxidase Inhibitors) treat
gout by blocking uric acid formation
47
XOI side effects
anti diabetes meds: hypotension, hypoglycemia
48
Uricosuric treat
gout by lower/inhibit renal reabsorption of uric acid so excreted out in urine, decrease serum uric acid
49
Uricosuric risk
kidney stones
50
Uricosuric not to be taken with
aspirin and thiazide diuretics
51
gout hydration amount and reason
2L to prevent kidney stones
52
osteoarthritis level of activity
moderate
53
osteoarthritis s/s
stiff joints b/c loss of synovial fluid crepitus no inflammation worse pain bad weather
54
osteoarthritis and WBC
WBC WNL b/c no systemic inflammation, just local swelling
55
osteoarthritis assessment
morning stiffness: 30 minutes
56
tylenol / acetaminophen
max 4000 mg/ 4g
57
osteoarthritis hot or cold
temperature treatments hot and cold
58
osteoarthritis meds
COX2 Inhibitors / celecoxib / celebrex for local inflammation
59
COX2 Inhibitors / celecoxib / celebrex side effects
cardiovascular problems, MI, CVA, high BP
60
autoimmune local?
systemic
61
systemic example
dry mucus membranes, wrist pain, cold feet
62
RA unilateral
bilateral
63
RA assessment
morning stiffness 1 hour
64
Rheumatoid Factor RF specific to RA
no, all inflammation have high RF
65
arthrocentesis fluid color
synovial fluid s/b clear, not cloudy or milky (b/c antibodies in it)
66
any med that treats inflammation risk
infection b/c WBC inhibited
67
Tumor Necrosis Factor (TNF) treat
RA
68
Tumor Necrosis Factor (TNF) side effects
TB so manteaux test before, no live vaccines
69
dairy and inflammation
can cause it
70
SLE risk factors
15-40 YO, black and hispanic women,
71
SLE cause
anti-DNA antibodies, blood vessels attacked/inflamed
72
SLE and kidneys
lupus nephritis
73
SLE and skin
rash, photosensitivity, butterfly rash,
74
Scleroderma definition
connective tissue disease, hardening of the skin
75
Scleroderma effects
loss of skin elasticity incl lungs, esophagus and GI tract hardening
76
Scleroderma interventions
impaired swallowing and constipation
77
RA s/s
bilateral joint pain, weight loss, joint deformed, tinnitus, GERD
78
SLE s/s
fever, nephritis
79
ANA serum test to
diagnose
80
ESR blood test to
evaluate treatment
81
pannus is
highly vascular granulation tissue
82
SLE usually linked to
Scleroderma
83
Rheumatoid Arthritis (RA) vs Osteoarthritis (OA) similarities
1. RA and OA both forms of arthritis which is pain in the joints 2. both chronic 3. both
84
RA vs OA type of disease
RA autoimmune | OA "wear and tear" over time, degenerative, destroys cartilage in synovial joints and vertebrae
85
RA vs OA symptoms
RA joint pain, inflammation, stiffness | OA joint pain, non inflammatory, stiffness
86
RA vs OA location
RA inflammation in pairs of smaller joints, both hands, both ankles, etc OA weight bearing joints (back, hip, knee)
87
RA vs OA timing
RA worse in morning for at least 1 hour | OA morning for 30 minutes, gets worse with activity during day
88
RA vs OA systemic symptoms
RA, systemic fatigue, weight loss, weakness | OA, localized

Nursing 2 (9 decks)

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